A four-year audit of secondary prevention in a single general practice

Scotland has one of the highest mortality rates for ischaemic heart disease (IHD) in the world, accounting for one quarter of all deaths. Much evidence demonstrates aggressive management of risk factors can make a significant difference to this high morbidity and mortality. Current evidence suggests that secondary prevention of IHD is currently not carried out well in primary care in the UK. Our practice set out to see if this could be improved by using computer records. Over the course of four years more than 80% of IHD patients are now on aspirin, almost 90% have blood pressure recorded annually (average 130/74 mmHg), 82% are non-smokers, 84% have an annual cholesterol check, 65% have a cholesterol < 5 mmol/L, 56% are on a cholesterol-lowering drug (average cholesterol is 4.76 mmol/L), 61% are on cardioprotective drugs, and there was one acute infarct. We suggest that secondary prevention can be improved at a practice level with a good recording system, and a motivated primary care team.